Although these affiliations seem encouraging, teaching hospitals may find it more difficult to eventually link up with HMOs, which are generally unwilling to pay for the higher priced services of teaching hospitals.

Current Plans in Congress

Most of the hospital representatives said they had not officially endorsed any particular health-care plan currently being considered in Congress.

And Gaintner says he doubts Congress will be able to pass anything truly substantive.

"I don't think very much is going to happen in Washington," he says. "Most of us are pretty skeptical."

"It's possible they might pull a rabbit out of a hat," says Corlette. "If anything, it will be a scaled down version, maybe covering 92 percent of people, but even that's hard to achieve." According to Corlette, 85 percent of the population is now insured.

The University and the teaching hospitals generally support President Clinton's push for broader insurance coverage.

"When people don't have insurance, it makes for bad health care," says Corlette. "Women who get pregnant don't go to sex doctors or get the appropriate vaccinations. We are the only Western democracy that does not have universal coverage. It does seem a shame."

But Harvard's teaching hospitals still have problems with aspects of some other Congressional proposals.

Gaintner says he is "very against" massive funds being taken away from Medicare and Medicaid. "You don't rob Peter to pay Paul," he says.

Teaching hospitals also oppose a measure in Congress requiring that 55 percent of all residents be trained as primary care physicians by the year 2001.

"We would feel that it is not reasonable for all hospitals to look like each other," says Corlette. Harvard's teaching hospitals now train mostly specialists, not primary care physicians.

Favorable Subsidies

Of special importance to teaching hospitals is their bid to levy a fee on all insurers to support their educational programs, says Corlette.

"I think probably the ideal ought to come from a combination of the government and the private sector," Gaintner says. "The private sector benefits from our activities as well."